Insurer Market Conduct Resources and Information | HAP

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Advocacy

State Oversight of Health Insurer-Provider Contracts

There are important health insurance market and delivery system issues that are developing across the commonwealth. In response, the state legislature is considering changes in state oversight of insurer and hospital contracts.

HAP believes there is a compelling public policy interest for the state to ensure that there is a competitive insurance market to enable broad access to coverage.

However, HAP opposes legislation that would result in a regulatory framework that either:

  • Prevents health care providers from being able to effectively structure contractual relationships with health plans
  • Unduly interferes with insurance market competition

Payor Practices Reform

 HAP supports House Bill 1194, sponsored by Representative Steven Mentzer (R-Lancaster), to protect against inappropriate use of prior authorization practices. That action leads to delays in patients receiving medically necessary care and creates significant administrative burdens for providers, which further detracts from patient care.

Additionally, inappropriate use of prior authorization has been shown to increase health care costs for businesses, consumers, and government payors, and also has a significant impact on quality of care. A survey of health care practitioners shows that 92 percent report prior authorization having a negative impact on patient clinical outcomes.

Related News

August 22, 2019

HAP Endorses Federal Effort to Protect Patients from Delays in Care, Lauds Rep. Mike Kelly’s Efforts to Standardize Prior Authorization

HAP has joined more than 300 patient, physician, health care professional, and other health care stakeholder organizations in expressing support for bipartisan legislation that would help protect patients from unnecessary delays in care.


July 31, 2019

ACA Plans Increase Consumer Options; Request Modest Increases

Pennsylvania's Insurance Commissioner released the 2020 requested rate filings for health insurance plans, highlighting greater consumer choice.


July 24, 2019

33 PA Health Care Groups Agree: Reform Insurance Prior Authorization Practices

In HAP’s latest blog, President and CEO Andy Carter shares how a coalition of 33 health care organizations that represent Pennsylvania providers is calling for commonsense reforms to protect against prior authorization red tape that can keep patients from getting the health care they need when they need it.


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